Ari Buse Cagla, Sahin Elifnaz
Neurology, Bahcesehir University Medical Faculty, Istanbul, TUR.
Cureus. 2023 Nov 2;15(11):e48165. doi: 10.7759/cureus.48165. eCollection 2023 Nov.
In the process of differential diagnosis concerning chronic abdominal wall pain (CAWP), several conditions are typically considered, including abdominal wall hernias, endometriosis, thoracic nerve radiculopathies, xiphoidalgia, and lower rib pain syndromes. Notwithstanding these, there exists an additional condition that is often overlooked initially: anterior cutaneous nerve entrapment syndrome (ACNES). This syndrome is characterized by the entrapment of cutaneous nerve branches responsible for supplying the abdominal wall. The diagnostic procedure for this condition can present notable challenges.
The subject of concern was a male patient aged 30, who presented with persistent CAWP. Despite conducting comprehensive analyses of his blood, urine, and imaging studies, no anomalies were detected. However, he exhibited positive results for the pinch test and Carnett's sign. Based on the outcomes of his clinical assessment, the patient received a diagnosis of ACNES. Subsequent administration of gabapentin resulted in a notable alleviation of his symptoms.
This case report highlights the referral of a patient to a neurology clinic owing to abdominal wall pain. Given the rarity of ACNES reports, our objective was to delineate the findings of our patient, with the aim of augmenting clinicians' understanding of this condition.
在慢性腹壁疼痛(CAWP)的鉴别诊断过程中,通常会考虑几种情况,包括腹壁疝、子宫内膜异位症、胸神经根病、剑突痛和下肋疼痛综合征。尽管如此,还有一种情况最初经常被忽视:前皮神经卡压综合征(ACNES)。该综合征的特征是负责供应腹壁的皮神经分支受到卡压。这种疾病的诊断过程可能会带来显著挑战。
患者为一名30岁男性,患有持续性CAWP。尽管对其血液、尿液和影像学检查进行了全面分析,但未发现异常。然而,他的捏压试验和卡内特征结果呈阳性。根据临床评估结果,该患者被诊断为ACNES。随后给予加巴喷丁治疗,其症状得到明显缓解。
本病例报告强调了因腹壁疼痛而将患者转诊至神经科诊所的情况。鉴于ACNES报告较为罕见,我们的目的是描述该患者的检查结果,以增强临床医生对这种疾病的了解。